NEW ORLEANS and SOUTH SAN FRANCISCO, Calif., Dec. 9, 2013 (GLOBE NEWSWIRE) -- Portola Pharmaceuticals (Nasdaq:PTLA) today announced additional results of a Phase 2 proof-of-concept study that showed andexanet alfa's ability to immediately reverse the anticoagulation activity of XARELTO® (rivaroxaban) through the administration of a short intravenous bolus. The data also showed that this reversal can be prolonged if needed by a continuous infusion. Andexanet alfa was well tolerated, with no serious adverse events reported. The data were presented at the 55th American Society of Hematology (ASH) Annual Meeting in New Orleans by lead investigator Mark Crowther, M.D., M.Sc., associate chair, Department of Medicine, McMaster University, Hamilton, Ontario.
Andexanet alfa has the potential to be a first-in-class universal antidote designed to reverse the anticoagulant activity of Factor Xa inhibitors in patients who experience an uncontrolled bleeding episode or who require emergency surgery. By the year 2020, Portola estimates that the number of patients presenting to the hospital who could benefit from an antidote may approach 500,000 in the United States, Japan and the five largest European Union countries alone. In November 2013, andexanet alfa was designated as a breakthrough therapy by the U.S. Food and Drug Administration.
"We have now shown that andexanet alfa produces immediate, dose-dependent and well-tolerated reversal of multiple Factor Xa inhibitors. Andexanet alfa's unique flexibility to provide short-term reversal through the administration of an intravenous bolus or sustained reversal by the addition of an extended infusion is critical in covering the multiple clinical scenarios where a reversal agent is needed," said John T. Curnutte, M.D., Ph.D., executive vice president of research and development for Portola. "Importantly, we believe andexanet alfa's highly specific mechanism of action may minimize complications that can be associated with agents that have off-target activity."
Phase 2 Study Design and Results
The randomized, double-blind, placebo-controlled, cohort dose-escalation Phase 2 proof-of-concept study treated healthy volunteers with an oral dose of XARELTO® at 20 mg once daily for six days and then randomized 36 volunteers in a 6:3 ratio to andexanet alfa in four different dosing cohorts. The first three cohorts received a single IV bolus of andexanet alfa at 210 mg, 420 mg or 600 mg, respectively. A fourth cohort received a single IV bolus of andexanet alfa at 720 mg followed by a 4 mg/minute infusion for one hour.
Immediately following completion of the 210 mg, 420 mg, 600 mg and 720 mg bolus doses of andexanet alfa, anti-Factor Xa activity decreased dose-dependently by 20 percent, 53 percent, 70 percent and 81 percent, respectively, from the pre-andexanet alfa level and returned to placebo levels approximately two hours after treatment. In parallel, the plasma concentrations of unbound XARELTO® were decreased by 32 percent, 51 percent, 75 percent and 70 percent respectively, relative to pre-andexanet alfa values. XARELTO®-induced inhibition of thrombin generation and prolongation of both prothrombin time and activated clotting time approached normal levels with andexanet alfa in a dose-dependent manner.
Safety data showed that andexanet alfa was well tolerated, with no thrombotic events or serious adverse events reported. No antibodies to Factor Xa or Factor X were observed in this or other Phase 2 studies, which have included a total of more than 80 volunteers.
Investor Briefing Webcast Details
Portola will host an investor briefing today, Monday, December 9, at 2:05 p.m. Central Time (3:05 p.m. Eastern Time) during the ASH Annual Meeting in New Orleans. During the event, Portola's senior management team will provide an update on the Company's recent business progress. A live webcast of the event will be available via the Investor Relations section of the Company's website at www.portola.com. A replay will be available on the Company's website for 30 days following the live event.
About Andexanet Alfa (PRT4445*)
Andexanet alfa is a first-in-class recombinant, modified Factor Xa molecule being developed as a direct reversal agent (antidote) for patients receiving a Factor Xa inhibitor who suffer an uncontrolled bleeding episode or who require emergency surgery. Andexanet alfa acts as a Factor Xa decoy that targets and sequesters with high specificity both direct and indirect Factor Xa inhibitors in the blood. Once bound, the Factor Xa inhibitors are unable to bind to and inhibit native Factor Xa, thus allowing for the restoration of normal hemostatic processes. Through its mechanism of action, andexanet alfa has the potential to act as a universal antidote and address the direct cause of the patient's inhibited clotting activity without being prothrombotic.
Andexanet alfa has been designated as a breakthrough therapy by the U.S. Food and Drug Administration (FDA). The FDA's breakthrough therapy designation is intended to expedite the development and review of drugs for serious or life-threatening conditions.i Portola is pursuing an Accelerated Approval pathway for andexanet alfa and plans to initiate registration-enabling studies in 2014 to potentially bring this therapy to patients in need.
The Company has reported data from its ongoing Phase 2 proof-of-concept studies of andexanet alfa and the Factor Xa inhibitors Eliquis® and XARELTO®. Additional studies are ongoing with Lovenox® (enoxaparin), Lixiana® and Portola's investigational oral Factor Xa inhibitor, betrixaban, which is being studied in a Phase 3 clinical trial and has the potential to be the first oral Factor Xa inhibitor approved for venous thromboembolism (VTE) prevention in acute medically ill patients. Portola has entered into clinical collaboration agreements with all of the manufacturers of direct Factor Xa inhibitors, including Bristol-Myers Squibb and Pfizer (Eliquis® [apixaban]), Bayer HealthCare and Janssen Pharmaceuticals (XARELTO® [rivaroxaban]), and Daiichi Sankyo (Lixiana® [edoxaban]), while retaining all rights to the program.
About Portola Pharmaceuticals, Inc.
Portola Pharmaceuticals is a biopharmaceutical company focused on the development and commercialization of novel therapeutics in the areas of thrombosis and hematology.
Betrixaban
Portola's wholly-owned lead compound, betrixaban, is a novel, oral, once-daily Factor Xa inhibitor in Phase 3 development for extended-duration prophylaxis of venous thromboembolism (VTE) in acute medically ill patients. Betrixaban's properties may be uniquely suited to potentially demonstrate efficacy without significantly increasing bleeding in this patient population. Currently, there is no anticoagulant approved for extended-duration VTE prophylaxis in acute medically ill patients.
Andexanet Alfa* (PRT4445)
Portola's second lead development candidate, andexanet alfa (PRT4445), has the potential to be a first-in-class universal antidote to directly reverse the effects of Factor Xa inhibitors in patients who suffer an uncontrolled bleeding episode or who require emergency surgery. Portola retains full, worldwide commercial rights to andexanet alfa, which has been designated as a breakthrough therapy by the U.S. Food and Drug Administration.
Cerdulatinib* (PRT2070) and PRT2607
Portola's third product candidate, cerdulatinib (PRT2070), is an orally available kinase inhibitor that uniquely inhibits two validated tumor proliferation pathways -- spleen tyrosine kinase (Syk) and janus kinase (JAK). It is currently being studied in patients with genetically-defined hematologic cancers, as well as for patients who have failed therapy due to relapse or acquired mutations. Portola's fourth program is partnered with Biogen Idec and is focused on the development of PRT2607, a selective Syk inhibitor. For more information, visit www.portola.com.
Forward-looking statement
Statements contained in this press release regarding matters that are not historical facts are "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995. Because such statements are subject to risks and uncertainties, actual results may differ materially from those expressed or implied by such forward-looking statements. Such statements include, but are not limited to, statements regarding: Portola's plans for future clinical studies and pursuit of an Accelerated Approval process for andexanet alfa, anticipated growth in the market for anticoagulants, and the potential efficacy, safety, and activity of andexanet alfa, betrixaban, and cerdulatinib. Risks that contribute to the uncertain nature of the forward-looking statements include: the accuracy of Portola's estimates regarding its ability to initiate and/or complete its clinical trials; the success of Portola's clinical trials and the demonstrated efficacy of Portola's product candidates thereunder; the accuracy of Portola's estimates regarding its expenses and capital requirements; regulatory developments in the United States and foreign countries; Portola's ability to obtain and maintain intellectual property protection for its product candidates; and the loss of key scientific or management personnel. These and other risks and uncertainties are described more fully in Portola's most recent filings with the Securities and Exchange Commission. All forward-looking statements contained in this press release speak only as of the date on which they were made. Portola undertakes no obligation to update such statements to reflect events that occur or circumstances that exist after the date on which they were made.
*Andexanet alfa and cerdulatinib are proposed International Nonproprietary Names (pINN).
i New England Journal of Medicine 369:20; November 14, 2013. http://www.nejm.org/doi/pdf/10.1056/NEJMp1311439. Accessed November 23, 2013.